Scholarship Application – Returning Scholars "*" indicates required fields CompanyThis field is for validation purposes and should be left unchanged.Family Name:*First Name(s):*Title:* Mr Ms Mrs Miss Other Postal Address:* Street Address Address Line 2 City ZIP / Postal Code Email:* Mobile Phone:*Attach any new qualifications, including any relevant transcripts or documentation of courses, level pass rates etc:*Max. file size: 100 MB. Shareholder or Whānau Trust DetailsShareholder's Name or Whānau Trust Name:*If the Shareholder is a Whānau Trust please provide name of the donor of the shares & Responsible Trustee:Shareholder Number (if known):About Your CourseQualification to be completed during the Scholarship:*Date of enrolment:* DD slash MM slash YYYY Do you expect to complete your diploma/degree this year?* Yes No Date of expected completion:* DD slash MM slash YYYY Are you considering post graduate studies?* Yes No Please provide details:*Institution at which you will be enrolled:*Schedule and/or invoice of the cost of your study for the year:*Max. file size: 100 MB. Bank Details - Only if you have a new bank account:Max. file size: 100 MB. Are you receiving/applying for other Scholarships/Grants/Bursaries?* Yes No Other Scholarship/Grant/Bursary Details:*If receiving or applying for multiple other scholarships, grants or bursaries, click on the plus symbol to add another row to add the details.Amount:From: Add RemoveTotal:*Have you changed your course of study?* Yes No Please provide details:*Please write a reflection of your learning / experiences at University / other studies to date:*Additional NotesAcknowledgement* I hereby certify that the information set out on this application form is correct Signature of applicant:*Date* DD slash MM slash YYYY This field is hidden when viewing the formFor Office Use OnlyThis field is hidden when viewing the formGrant History
